Medical instrument



Jan. 3, 1956 I F. c. SPENCER 2,729,210

MEDICAL INSTRUMENT Filed June 22, 1954 I N VEN TOR Fran/l 6'. 3062270121- ATTORNEYS United States Patent in 2,129,210. A

MEDICAL INSTRUMENT I I Frank C. Spencer, Honolulu, Territory of HawaiiApplication June 22,1954, Serial No. 438,450

. 7 Claims. 01. 128-2) This invention relates to a surgical instrumentused for diagnostic purposes. More particularly, this invention relatesto a "surgical instrument which is adapted to remove circumferentialsamples of tissue from body cavities, such as the cervix of the uterus.

'lt iswell known'to those skilled in the medical arts that cancer of thecervix'in its early stages is a purely local disease and, if detected,may bej'successfully treated without permanently damaging thereproductive system. As' it is extremely desirable to detect anymalignancy in it's early stages, it has become a universally acceptedpractice to include a cervical scraping in the physical examinations ofwomen of cancer age. I

Various instruments for performing the scraping operationha've beenproposed, but these instruments have had a cutting edgeformed integralwith the body of the instrument-itself, so that any dulling or chippingof the curetting edge renders it useless and requires a replacement' ofthe entire instrument.

lt has also been found that an instrument having an integral cuttingedge has several other inherent disad- 9 vantages, such as its lack ofversatility. For example, the instruments presently in use do not allowthe technician to selectively determine the amount or thickness of the.

specimen of the cervical epithelium which is to be 'removed. 'lfwill bereadily seen that his desirable to be able to vary the depth of cut ofthe scraping instrument so that, upon occasion, the technician mayobtain samples of cells which will disclose the location ofnon-invasivecarcinoma which may be present intra-epithelially.

Ithas also been found that on some occasions it is desirable to vary therelative sharpness of the cutting edge; for example, when the patient issuffering cervictis or endometritus, the condition and firmness of thetis- The'se'ahd other objectsof my'invention will be fully understood;from the following detailed description of a typical'preferred form andapplication of the invention, throughout which description reference ismade to' aucollar, 1 2 thereon adjacent oneend thereof, which may beeither iwelded; threadablyengaged, pinned, or shrink fitted on the stem'10. e a

The shoulder is shaped to a double frusto-cone with the-surface-14,towards the handle, and the surface 16, towards the free-endof thestern, sloping inwardly towards the axis of the stem. The end portion ofthe stem 10, adjacent the collar 12, is reduced in size at 17 andcarries-a frusto-conical collar 1 8 fixed thereto-"The freeend 19of thestem is threaded to threadably engage a blade clamp 20, as will bediscussed hereinafter.

A blade supporting head; generally indicated at 22, comprises t an openended 'frusto-conical tubular element \vhichha's'a portion of-itslongitudinally extending side wallwut fa w'ay to form a planar surface24 which is parallel with a locus line of its sidewall surface. A

l further portion of its s ide'wall is cutaway, as at 26, to

sue are at a variance from the norm, and this will affect agiven cuttingedge. V v

It will, therefore be readily seen that a cervical scraper having areplaceable or interchangeable blade arrangement'can replace a pluralityof instruments of the con:

the size and characteristics of a specimenprocured with .ventionaldesign. Thus, such an improvement will not only reduce the cost ofproviding cervical scraping instruments, but will also serve to reducethe sum total of the'iiumber of instruments required by'modern medicalpractice. 1 t 7 It is, therefore, an object of this invention to providea cervical scraper which is adapted for use in routine vaginalexaminations. I

It is another object of this invention to provide a cervical scraperwhich is provided with a replaceable blade. [it is another object ofthis invention to provide a. cervical scraper which is provided with areplaceable bladewhich may be selectively installed to provide vary-;ing depths of cutting or sampling.

It is still another object of this invention to provide a cervicalscraper which may be used for obtaining a continuous circumferentialepithelial specimen from the cervical canal.

define a longitudinally extending opening into the interior or lumenof'the' blade supporting head. The reduced-portion of thestem 10is'inserted within, and ex-- tends through, the lumen of the bladesupporting head 22; that is tosayfthe blade supporting element isdisposed circumjacent the'stem 10 between the'collar 12 and the free.end-of the stem 19: The inner'surface 30 of the major end of the bladesupporting head 22 abuts against the tapered surfaced-6 of the collar12, and the inner surface of its minor end' rests on, and forms a snugfit with, the peripheral-surface of the collar 18, which has a tapercongruent with the inner surface 30. The blade clamp, as discussedhereinabove, is threadably engaged with the threaded free end 19 of thestem, as shown in Figure .2, and has an exterior surface which is gentlyrounded to preventthe injury or bruising of delicate organs. its wallsurface is formed to make a flush union withhthe minor end of thebladesupporting head 22. The blade clamp has a shoulder 32 which extendsover the planar surface'24 when the bladeclamp is drawn tight into anab'utting'relationship with the minor end of thebl'ade supporting head22. 'It shouldbe mentioned here that such aselective tightening of theblade clamp 20 on the threaded end 19 of the sterr'ij10 will cause themajor endof the blade support to ridefup on surface 16, which has agr'eater'taper than inner surface 30, until it is juxtaposed with atight forced fit.

As shown in. Figures 1,2 and 3, the planar surface 24, which defines ablade support, extends longitudinally of the surfaceof the bladesupporting head 22. t A short lip 34, which .is integral. with thesidewall of the blade uppenor exterior'surface which conforms to the generalconfiguration of the blade supporting head 22. The undersurface of thelip 34 is spaced from the planar. sur- Patente d Jan. 3, 1956 face adistance substantially equal to the thickness of a suitable blade 36. if'v j 4 As best shown in Figures 55 and 3, the shoulder clamp 32'has aflat undersurface which is parallel with planar surface 24 and has anupper or exterior surface which conforms to the general'configuration ofthe blade supporting head 22. The undersurface of theshoulder 32 isspaced from the planar surface a distance substantially equal to thethickness of a suitable blade 36. 1

- It will be seen that the shoulder 32 and one end of the planarsurface24, and the lip 34 and the other end of the planar surface 24,define blade receiving grooves to confine and hold the blade 36 which isdisposed upon the planar surface 24. As best illustrated in Figures 1and 4, the blade is selectively located on the planar surface 24 withits cutting edge .38 everted slightly beyond the normal root circles ofthe ,frusto-conical blade supporting head 22.

It will be readily seen that the technician may select any of a largenumber of blades having varying degrees of sharpness and that the bladesmay be selectively locat'ed with the edges projecting from the rootcircles of thehead 22 any desired distance. The technician is thus ableto effectively control the depth of cut of the instrument.

, In use, the instrument is provided with a suitable blade, installedwith the desired bite" or depth of cut, and is inserted into thecervical canal after the cervix has been exposed by a vaginal speculum.While the instrument is being directed to its operative position, it isso manipulated that the cutting edge 38 of the blade does not contact ordamage the walls of the vagina or the entrance of the cervix. This maybe done by holding the instrument to one side of the passages and alsoby rotating the instrument in a counterclockwise direction, as viewed inFigure 4. The blade 36 is formed to present a cutting edge 38 on itsunderside, so that counterclockwise rotation of the instrument, asviewed in Figure 4, will not cut or damage tissue in contact with theblade.

As shown in Figure 4, as the instrument has a conical surfaceconfiguration, which conforms to the general shape of the cervicalcanal, the instrument will maintain a close contact with the walls 40thereof. The instrument is then rotated in a clockwise direction, asviewed in Figure 4, so that the cutting edge 38 of the blade 36 willpeel off a thin, continuous strip of the epithelium. The specimen strip42 is directed by the undersurface of the blade 36 into the lumen of theblade supporting head which forms a tissue specimen receiving reservoir.When the instrument has through an entire revolution, a completecircumferential sample of the wall of the cervical canal will beretained within the tissue specimen reservoir. The instrument may thenbe withdrawn, while being rotated counterclockwise, as-viewed in Figure4, so that the blade will not cause any damage to the walls of thevagina.

By rotationally orienting the instrument before the cutting operation isbegun, it is possible for the technician to determine, upon subsequentexamination, the exact area of the cervical canal from which aparticular portion of the stripof tissue was removed. This isparticularly helpful when malignancy is at an early stage and islocalized in one portion of the cervix.

-Having described only a typical preferred form and application of myinvention, I do not wish to be limited or restricted. to specificdetails herein set forth, but wish to reserve. to myself any variationsor'modifications that may appear to those skilled in the art and fallingwithin the scope of the following claims:

.1 laim? I l l. A curetting instrument for obtaining a continuouscircumferential specimen tissue strip from a body cavity been rotatedcomprising: a stem; a frusto-conical hollow blade support secured tosaid stem, a portion of the peripheral wall of said blade supportbeingfcut away to define a planar blade supporting surface parallel witha locus line of said frusto-conical blade support, an adjacent portionof the wall being cut away to define a longitudinal openingcommunicating with the lumen of the blade support; and means to clamp areplaceable longitudinally extending blade on said planar surface.

2. In the structure defined in claim 1, a replaceable blade on saidsurface with a cutting edge everted from a line defining the loci of theroot circles of the blade support.

3. A curetting instrument for obtaining a continuous circumferentialspecimen tissue strip from a body cavity comprising: a stem; a hollowfrusto-conical blade support, a portion of one side of said bladesupport being formed to define a planar blade supporting surface; acollar on said stem adjacent one end thereof; said blade support beingdisposed circumjacent said stern between said collar and said end, withthe major end of said blade support abutting said collar; a blade clampfixable on said end of said stem and abutting the minor end of saidblade support; a replaceable blade held on said surface by said bladeclamp, said blade support being formed with a longitudinal openingdefined by said blade and said blade support communicating with thelumen of said blade support to receive strips of tissue gathered by saidblade.

4. A curetting instrument for obtaining a continuous circumferentialspecimen tissue strip from a body cavity comprising: a stem; atfrusto-conical hollow head circumjacent one extremity of said stem, alongitudinally extending portion of the periphery of said head beingformed to present a planar surface to support a replaceable cuttingblade; a longitudinally extending opening in said head to receive atissue strip cut by the blade; the lumen of said head defining a tissuereceiving chamber; a blade clamp fixable on the end of said stem; ashoulder on said blade clamp extending over said planar surface todefine a blade retaining slot.

'5. A curetting instrument for obtaining a continuous circumferentialspecimen tissue strip from a body cavity comprising: a stern; a hollowfrusto-conical blade support; a collar on said stem adjacent one endthereof; said blade support being disposed circumjacent said stembetween said collar and said end, with the major end of said bladesupport abutting said collar; a blade clamp fixable on said end of saidstem and abutting the minor end of said blade support; said bladesupport being formed with a longitudinal opening communicating with itslumen to receive the strip of tissue.

6. In the structure defined in claim 5: a longitudinally extendingportion of the periphery of said blade support being formed to present aplanar surface to support a replaceable cutting blade; a shoulder onsaid blade clamp extending over said planar surface to define a blade retaining slot; a lip cantilevered from said blade support over saidplanar surface to define a second blade retaining slot.

7. A curetting instrument for obtaining a continuous circumferentialspecimen tissue strip from a body cavity comprising: a stem; a hollowblade support, circular in cross-section, secured to said stem, aportion of the peripheral wall of said blade support being cut away todefine a planar blade supporting surface parallel with a locus line ofsaid blade support, an adjacent portion of the wall being cut away todefine a longitudinal opening communicating with the lumen of the bladesupport; and means to clamp a replaceable longitudinally extending bladeon said planar surface.

No references cited.

